Acute Abdomen

Ira Shah
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Acute Abdomen - Introduction
Abdominal pain is one of the most common presentations in the pediatric emergency department. The most important concern is to decide if the condition requires surgical intervention or can be managed medically.

What is important is to note whether the pain is constant or colicky and the site and radiation of pain. Also, other associated features such as nausea, vomiting, bowel or urinary complaints, vaginal bleeding aid in the diagnosis. Clinical examination findings such as presence of fever, tenderness, rigidity (indicates peritoneal inflammation), organomegaly, increased/decreased bowel sounds, pallor, jaundice usually helps to determine the cause of pain.

In first few years of life:
- Congenital abnormalities
- Incarcerated inguinal hernia
- Intussuception
- Intestinal volvulus
- GI perforation
- NEC in preterm neonates
In older children:
- Trauma
- Pancreatitis
- Meckel's diverticulum
- Primary peritonitis
- Intestinal worm infestation
In adolescents:
- Acute appendicitis
- Cholecystitis (acalculous)
- Testicular torsion
- Rupture of ovarian cyst

Non- surgical causes of abdominal pain:
- Hyperthyroidism
- Addison's disease
- Diabetic ketoacidosis
- Hypercalcemia
- Lead poisoning
- Porphyria

Non-specific abdominal pain
It is the most common cause of abdominal pain in late childhood and early adolescence. It is a colicky pain with some localization that becomes worse after meals. Bowel sounds may be increased and a palpable mass of feces may be present in right or left iliac fossa. The causes commonly are constipation, irritable bowel and chronic spasm.

The treatment consists of antispasmodics.


Acute Abdomen Acute Abdomen 02/23/2001
Acute Abdomen - Investigations >>
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